A bad night could be anything from being sick to, being aggressive when drunk and getting into a fight or the potentially fatal consequences of alcohol poisoning. 

If you and your friends choose to drink alcohol, all of this can be avoided if you take a little extra care throughout the night and don’t drink above the alcohol unit guidelines. We spoke to medical experts to find out how you can:

  • spot the signs that a friend might be drinking too much
  • help when things have already become urgent
  • prevent a good night turning into one you regret.

Spotting the signs

Early signs that a friend might be drinking too much include their speech becoming slurred and being unsteady on their feet. This is because as alcohol is a depressant it slows down the brain and affects the body’s responses. Dr Sarah Jarvis, a London-based GP, and member of Drinkaware’s Medical Advisory Panel, says facial flushing is also a good early indicator that someone is drinking a lot. She adds: “The most noticeable sign that someone is becoming intoxicated is lowered inhibitions. A quiet person will become loud, and a loud person even louder.”

Look around you and there might be physical evidence that your friend is drinking too much such as a growing number of bottles and glasses. This could be something you mention to them so they’re aware of how much they’re drinking. Don’t be fooled into thinking they’re okay just because they’ve had the same number of drinks as you. How much alcohol someone’s body can drink depends on lots of things, like how much they’ve eaten that day, their general health, size and gender and how they’re feeling. Suggest to them you get some air together or a glass of water.

The degree to which someone’s speech and coordination is affected by alcohol is perhaps the best indicator of how much they have drunk. So, you might notice that someone who has gone beyond the early stages of drinking too much begins to fall down, stagger and slur even more. Professor Paul Wallace, Drinkaware’s Chief Medical Adviser, says you might also see your friend becoming increasingly irrational as alcohol affects judgement. “They could behave differently, becoming involved in arguments or perhaps being inappropriately sexual towards somebody,” he says.

Helping your friend

This is definitely the time when alarm bells should be ringing for you and where, if you haven’t already, step in and do what you can to stop your friend from drinking any more alcohol.  The way you do this is really important. Professor Wallace says it’s not about getting angry with your friend, but being supportive to make them realise why you’re concerned. “If your friend has drunk too much, they’re going to have lost their judgement and are likely to resent you if they think you’re trying to ruin their fun,” he says. “So, there’s an element of relying on your friendship to get you through.” Not acting at this stage might avoid this tricky conversation and situation – but could make things worse.

More serious cases

Alcohol poisoning occurs when a person drinks a toxic amount of alcohol, over a short period of time. Someone affected by alcohol poisoning is likely to:

  • have lost their coordination, so they won’t be able to stand up, but they may not have passed out
  • be vomiting
  • feel very confused
  • have epileptic-like seizures
  • not be breathing regularly
  • look pale or almost blue
  • feel very cold.

“It’s very dangerous when someone has these symptoms and best to seek medical help, especially if your judgement is impaired and you’ve been drinking too,” says Professor Wallace.

Paramedic Phil Guthrie has been working for the London Ambulance Service for 14 years. He is often called out to treat young people who have been pre-drinking at home or ‘have drunk too much, for example during happy hour. Although, during some hours of Friday and Saturday night, more than one in five 999 calls is down to alcohol1.

Phil says:

  • Get medical help if your friend can’t stay awake, has vomited a lot and has been injured, especially if they have a head injury
  • If your friend needs medical help, consider calling an ambulance. Other options include minor injuries units, walk-in centres, NHS 111, chemists, or you can make your own way to hospital. (Be aware you won’t be seen any faster if you arrive at a hospital in an ambulance with a friend who has drunk too much)
  • When you call 999, the call taker will talk through what to do for your friend and stay on the phone before an ambulance arrives
  • Advice about what you should do is different depending on how your friend is doing. But your friend should be lying on their side, kept warm, perhaps with a jacket over them. You should also stay with them to monitor them
  • DON’T move your friend from where they are, pour water into their mouth or over them to try and wake them up.

Click here for more symptoms of alcohol poisoning and advice about what to do.

Someone who has experienced alcohol poisoning can make a full recovery. In the ambulance or at hospital, they’ll be put on a drip to hydrate them and monitored while their liver processes the alcohol. If they’re left to ‘sleep it off’ without being monitored by you or a medical professional, they could be at risk of choking on their own vomit or of hurting themselves during a seizure.

“It’s best to talk to your friends about how much you’re going to drink before the night begins so you know the things to look for which might mean you’ve drank too much,” says Professor Wallace. “A fun night with friends doesn’t have to be about having a lot to drink.”

Preventative tips

  1. Get to grips with the low risk alcohol unit guidelines.Two pints of 4% strength beer puts a man over the lower risk unit guidelines. And three 20ml measures of 40% gin will put a woman close to the upper guideline limit. Track how many units you’re having with our Unit and Calorie Calculator.
  2. Set a spending limit. Allow yourself a set amount to spend on alcohol on an evening out so you don’t drink too much in a short space of time. Our MyDrinkaware can help you track how much you’re spending.
  3. Don’t drink before you leave home. ‘Pre-loading’ or drinking a lot at the start of the night often means cutting an evening short because you’re too tired – or ill – to stay out. If you are going to drink before going out, limit it to one pub standard measure.
  4. Eat up. Drinking alcohol on an empty stomach is never a good idea. If you know you are going to be drinking some alcohol, make sure you eat a substantial meal before to avoid any alcohol you do drink going straight to your head.
  5. Pace yourself. Make sure you drink at your own pace – you won’t win any prizes by keeping up with your mates, you’re more likely to lose out on a great night. Set the example by opting out of rounds and drinking water alongside any alcohol you do drink.
  6. Plan your journey home. You’re more likely to drink less if you know you’re getting the last bus or train, or have booked a taxi.

References-
(1) London Ambulance Service website. Alcohol-related 999 incidents, NHS Trust data from 2013/14. Accessed: 10/12/15. Available at: http://www.londonambulance.nhs.uk/news/alcohol-related_999_incidents.aspx